U.S. patent application number 16/442247 was filed with the patent office on 2020-12-17 for ambient clinical intelligence system and method.
The applicant listed for this patent is Nuance Communications, Inc.. Invention is credited to Guido Remi Marcel Gallopyn, Matthieu Hebert, Donald E. Owen, Mehmet Mert Oz, Paul Joseph Vozila.
Application Number | 20200395109 16/442247 |
Document ID | / |
Family ID | 1000004170289 |
Filed Date | 2020-12-17 |
United States Patent
Application |
20200395109 |
Kind Code |
A1 |
Owen; Donald E. ; et
al. |
December 17, 2020 |
AMBIENT CLINICAL INTELLIGENCE SYSTEM AND METHOD
Abstract
A method, computer program product, and computing system for
obtaining encounter information during a patient encounter;
processing the encounter information to detect the execution of a
physical event during the patient encounter, thus defining a
detected physical event; and deriving information for the detected
physical event.
Inventors: |
Owen; Donald E.; (Orlando,
FL) ; Gallopyn; Guido Remi Marcel; (Newburyport,
MA) ; Vozila; Paul Joseph; (Arlington, MA) ;
Oz; Mehmet Mert; (Baden, AT) ; Hebert; Matthieu;
(Beauharnois, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Nuance Communications, Inc. |
Burlington |
MA |
US |
|
|
Family ID: |
1000004170289 |
Appl. No.: |
16/442247 |
Filed: |
June 14, 2019 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
G10L 15/26 20130101;
G16H 10/60 20180101; G16H 15/00 20180101; G16H 40/20 20180101; G06K
9/00718 20130101 |
International
Class: |
G16H 15/00 20060101
G16H015/00; G06K 9/00 20060101 G06K009/00; G16H 10/60 20060101
G16H010/60; G16H 40/20 20060101 G16H040/20; G10L 15/26 20060101
G10L015/26 |
Claims
1. A computer-implemented method, executed on a computing device,
comprising: obtaining encounter information during a patient
encounter; processing the encounter information to detect the
execution of a physical event during the patient encounter, thus
defining a detected physical event; and deriving information for
the detected physical event.
2. The computer-implemented method of claim 1 wherein obtaining
encounter information during a patient encounter includes:
utilizing a machine vision system to obtain machine vision
encounter information during the patient encounter.
3. The computer-implemented method of claim 1 wherein deriving
information for the detected physical event includes: generating a
text-based description of the detected physical event; and
annotating a medical record to include the text-based description
of the detected physical event.
4. The computer-implemented method of claim 1 wherein deriving
information for the detected physical event includes: associating
the detected physical event with a defined procedure; and
memorializing the execution of the defined procedure.
5. The computer-implemented method of claim 1 wherein deriving
information for the detected physical event includes: determining
the appropriateness of the detected physical event.
6. The computer-implemented method of claim 5 wherein determining
the appropriateness of the detected physical event includes one or
more of: determining whether the detected physical event violates
any professional rules; determining whether the detected physical
event violates any civil rules; and determining whether the
detected physical event violates any criminal laws.
7. The computer-implemented method of claim 1 wherein the detected
physical event is associable with a verbal component.
8. The computer-implemented method of claim 1 wherein the detected
physical event includes the use of a physical device.
9. The computer-implemented method of claim 1 wherein the
information derived for the detected physical event includes:
machine vision encounter information; and audio encounter
information.
10. The computer-implemented method of claim 1 wherein the
encounter information includes one or more of: machine vision
encounter information; and audio encounter information.
11. A computer program product residing on a computer readable
medium having a plurality of instructions stored thereon which,
when executed by a processor, cause the processor to perform
operations comprising: obtaining encounter information during a
patient encounter; processing the encounter information to detect
the execution of a physical event during the patient encounter,
thus defining a detected physical event; and deriving information
for the detected physical event.
12. The computer program product of claim 11 wherein obtaining
encounter information during a patient encounter includes:
utilizing a machine vision system to obtain machine vision
encounter information during the patient encounter.
13. The computer program product of claim 11 wherein deriving
information for the detected physical event includes: generating a
text-based description of the detected physical event; and
annotating a medical record to include the text-based description
of the detected physical event.
14. The computer program product of claim 11 wherein deriving
information for the detected physical event includes: associating
the detected physical event with a defined procedure; and
memorializing the execution of the defined procedure.
15. The computer program product of claim 14 wherein deriving
information for the detected physical event includes: determining
the appropriateness of the detected physical event.
16. The computer program product of claim 15 wherein determining
the appropriateness of the detected physical event includes one or
more of: determining whether the detected physical event violates
any professional rules; determining whether the detected physical
event violates any civil rules; and determining whether the
detected physical event violates any criminal laws.
17. The computer program product of claim 11 wherein the detected
physical event is associable with a verbal component.
18. The computer program product of claim 11 wherein the detected
physical event includes the use of a physical device.
19. The computer program product of claim 11 wherein the
information derived for the detected physical event includes:
machine vision encounter information; and audio encounter
information.
20. The computer program product of claim 11 wherein the encounter
information includes one or more of: machine vision encounter
information; and audio encounter information.
21. A computing system including a processor and memory configured
to perform operations comprising: obtaining encounter information
during a patient encounter; processing the encounter information to
detect the execution of a physical event during the patient
encounter, thus defining a detected physical event; and deriving
information for the detected physical event.
22. The computing system of claim 21 wherein obtaining encounter
information during a patient encounter includes: utilizing a
machine vision system to obtain machine vision encounter
information during the patient encounter.
23. The computing system of claim 21 wherein deriving information
for the detected physical event includes: generating a text-based
description of the detected physical event; and annotating a
medical record to include the text-based description of the
detected physical event.
24. The computing system of claim 21 wherein deriving information
for the detected physical event includes: associating the detected
physical event with a defined procedure; and memorializing the
execution of the defined procedure.
25. The computing system of claim 21 wherein deriving information
for the detected physical event includes: determining the
appropriateness of the detected physical event.
26. The computing system of claim 25 wherein determining the
appropriateness of the detected physical event includes one or more
of: determining whether the detected physical event violates any
professional rules; determining whether the detected physical event
violates any civil rules; and determining whether the detected
physical event violates any criminal laws.
27. The computing system of claim 21 wherein the detected physical
event is associable with a verbal component.
28. The computing system of claim 21 wherein the detected physical
event includes the use of a physical device.
29. The computing system of claim 21 wherein the information
derived for the detected physical event includes: machine vision
encounter information; and audio encounter information.
30. The computing system of claim 21 wherein the encounter
information includes one or more of: machine vision encounter
information; and audio encounter information.
Description
TECHNICAL FIELD
[0001] This disclosure relates to intelligence systems and methods
and, more particularly, to ambient clinical intelligence systems
and methods.
BACKGROUND
[0002] As is known in the art, clinical intelligence is the
creation of medical reports and documentation that details the
medical history of medical patients. As would be expected,
traditional clinical documentation includes various types of data,
examples of which may include but are not limited to paper-based
documents and transcripts, as well as various images and
diagrams.
[0003] As the world moved from paper-based content to digital
content, clinical documentation also moved in that direction, where
medical reports and documentation were gradually transitioned from
stacks of paper geographically-dispersed across multiple
locations/institutions to consolidated and readily accessible
digital content.
SUMMARY OF DISCLOSURE
[0004] In one implementation, a computer-implemented method is
executed on a computing device and includes: obtaining encounter
information during a patient encounter; processing the encounter
information to detect the execution of a physical event during the
patient encounter, thus defining a detected physical event; and
deriving information for the detected physical event.
[0005] One or more of the following features may be included.
Obtaining encounter information during a patient encounter may
include: utilizing a machine vision system to obtain machine vision
encounter information during the patient encounter. Deriving
information for the detected physical event may include: generating
a text-based description of the detected physical event; and
annotating a medical record to include the text-based description
of the detected physical event. Deriving information for the
detected physical event may include: associating the detected
physical event with a defined procedure; and memorializing the
execution of the defined procedure. Deriving information for the
detected physical event may include: determining the
appropriateness of the detected physical event. Determining the
appropriateness of the detected physical event may include one or
more of: determining whether the detected physical event violates
any professional rules; determining whether the detected physical
event violates any civil rules; and determining whether the
detected physical event violates any criminal laws. The detected
physical event may be associable with a verbal component. The
detected physical event may include the use of a physical device.
The information derived for the detected physical event may
include: machine vision encounter information; and audio encounter
information. The encounter information may include one or more of:
machine vision encounter information; and audio encounter
information.
[0006] In another implementation, a computer program product
resides on a computer readable medium and has a plurality of
instructions stored on it. When executed by a processor, the
instructions cause the processor to perform operations including
obtaining encounter information during a patient encounter;
processing the encounter information to detect the execution of a
physical event during the patient encounter, thus defining a
detected physical event; and deriving information for the detected
physical event.
[0007] One or more of the following features may be included.
Obtaining encounter information during a patient encounter may
include: utilizing a machine vision system to obtain machine vision
encounter information during the patient encounter. Deriving
information for the detected physical event may include: generating
a text-based description of the detected physical event; and
annotating a medical record to include the text-based description
of the detected physical event. Deriving information for the
detected physical event may include: associating the detected
physical event with a defined procedure; and memorializing the
execution of the defined procedure. Deriving information for the
detected physical event may include: determining the
appropriateness of the detected physical event. Determining the
appropriateness of the detected physical event may include one or
more of: determining whether the detected physical event violates
any professional rules; determining whether the detected physical
event violates any civil rules; and determining whether the
detected physical event violates any criminal laws. The detected
physical event may be associable with a verbal component. The
detected physical event may include the use of a physical device.
The information derived for the detected physical event may
include: machine vision encounter information; and audio encounter
information. The encounter information may include one or more of:
machine vision encounter information; and audio encounter
information.
[0008] In another implementation, a computing system includes a
processor and memory is configured to perform operations including
obtaining encounter information during a patient encounter;
processing the encounter information to detect the execution of a
physical event during the patient encounter, thus defining a
detected physical event; and deriving information for the detected
physical event.
[0009] One or more of the following features may be included.
Obtaining encounter information during a patient encounter may
include: utilizing a machine vision system to obtain machine vision
encounter information during the patient encounter. Deriving
information for the detected physical event may include: generating
a text-based description of the detected physical event; and
annotating a medical record to include the text-based description
of the detected physical event. Deriving information for the
detected physical event may include: associating the detected
physical event with a defined procedure; and memorializing the
execution of the defined procedure. Deriving information for the
detected physical event may include: determining the
appropriateness of the detected physical event. Determining the
appropriateness of the detected physical event may include one or
more of: determining whether the detected physical event violates
any professional rules; determining whether the detected physical
event violates any civil rules; and determining whether the
detected physical event violates any criminal laws. The detected
physical event may be associable with a verbal component. The
detected physical event may include the use of a physical device.
The information derived for the detected physical event may
include: machine vision encounter information; and audio encounter
information. The encounter information may include one or more of:
machine vision encounter information; and audio encounter
information.
[0010] The details of one or more implementations are set forth in
the accompanying drawings and the description below. Other features
and advantages will become apparent from the description, the
drawings, and the claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] FIG. 1 is a diagrammatic view of an ambient clinical
intelligence compute system and an ambient clinical intelligence
process coupled to a distributed computing network;
[0012] FIG. 2 is a diagrammatic view of a modular ACI system
incorporating the ambient clinical intelligence compute system of
FIG. 1;
[0013] FIG. 3 is a diagrammatic view of a mixed-media ACI device
included within the modular ACI system of FIG. 2;
[0014] FIG. 4 is a flow chart of one implementation of the ambient
clinical intelligence process of FIG. 1;
[0015] FIG. 5 is a flow chart of another implementation of the
ambient clinical intelligence process of FIG. 1;
[0016] FIG. 6 is a flow chart of another implementation of the
ambient clinical intelligence process of FIG. 1;
[0017] FIG. 7 is a flow chart of another implementation of the
ambient clinical intelligence process of FIG. 1; and
[0018] FIG. 8 is a flow chart of another implementation of the
ambient clinical intelligence process of FIG. 1
[0019] Like reference symbols in the various drawings indicate like
elements.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
System Overview
[0020] Referring to FIG. 1, there is shown ambient clinical
intelligence process 10. As will be discussed below in greater
detail, ambient clinical intelligence process 10 may be configured
to automate the collection and processing of clinical encounter
information to generate/store/distribute medical reports.
[0021] Ambient clinical intelligence process 10 may be implemented
as a server-side process, a client-side process, or a hybrid
server-side/client-side process. For example, ambient clinical
intelligence process 10 may be implemented as a purely server-side
process via ambient clinical intelligence process 10s.
Alternatively, ambient clinical intelligence process 10 may be
implemented as a purely client-side process via one or more of
ambient clinical intelligence process 10c1, ambient clinical
intelligence process 10c2, ambient clinical intelligence process
10c3, and ambient clinical intelligence process 10c4. Alternatively
still, ambient clinical intelligence process 10 may be implemented
as a hybrid server-side/client-side process via ambient clinical
intelligence process 10s in combination with one or more of ambient
clinical intelligence process 10c1, ambient clinical intelligence
process 10c2, ambient clinical intelligence process 10c3, and
ambient clinical intelligence process 10c4.
[0022] Accordingly, ambient clinical intelligence process 10 as
used in this disclosure may include any combination of ambient
clinical intelligence process 10s, ambient clinical intelligence
process 10c1, ambient clinical intelligence process 10c2, ambient
clinical intelligence process 10c3, and ambient clinical
intelligence process 10c4.
[0023] Ambient clinical intelligence process 10s may be a server
application and may reside on and may be executed by ambient
clinical intelligence (ACI) compute system 12, which may be
connected to network 14 (e.g., the Internet or a local area
network). ACI compute system 12 may include various components,
examples of which may include but are not limited to: a personal
computer, a server computer, a series of server computers, a mini
computer, a mainframe computer, one or more Network Attached
Storage (NAS) systems, one or more Storage Area Network (SAN)
systems, one or more Platform as a Service (PaaS) systems, one or
more Infrastructure as a Service (IaaS) systems, one or more
Software as a Service (SaaS) systems, a cloud-based computational
system, and a cloud-based storage platform.
[0024] As is known in the art, a SAN may include one or more of a
personal computer, a server computer, a series of server computers,
a mini computer, a mainframe computer, a RAID device and a NAS
system. The various components of ACI compute system 12 may execute
one or more operating systems, examples of which may include but
are not limited to: Microsoft Windows Server.TM.; Redhat Linux.TM.,
Unix, or a custom operating system, for example.
[0025] The instruction sets and subroutines of ambient clinical
intelligence process 10s, which may be stored on storage device 16
coupled to ACI compute system 12, may be executed by one or more
processors (not shown) and one or more memory architectures (not
shown) included within ACI compute system 12. Examples of storage
device 16 may include but are not limited to: a hard disk drive; a
RAID device; a random access memory (RAM); a read-only memory
(ROM); and all forms of flash memory storage devices.
[0026] Network 14 may be connected to one or more secondary
networks (e.g., network 18), examples of which may include but are
not limited to: a local area network; a wide area network; or an
intranet, for example.
[0027] Various IO requests (e.g. IO request 20) may be sent from
ambient clinical intelligence process 10s, ambient clinical
intelligence process 10c1, ambient clinical intelligence process
10c2, ambient clinical intelligence process 10c3 and/or ambient
clinical intelligence process 10c4 to ACI compute system 12.
Examples of IO request 20 may include but are not limited to data
write requests (i.e. a request that content be written to ACI
compute system 12) and data read requests (i.e. a request that
content be read from ACI compute system 12).
[0028] The instruction sets and subroutines of ambient clinical
intelligence process 10c1, ambient clinical intelligence process
10c2, ambient clinical intelligence process 10c3 and/or ambient
clinical intelligence process 10c4, which may be stored on storage
devices 20, 22, 24, 26 (respectively) coupled to ACI client
electronic devices 28, 30, 32, 34 (respectively), may be executed
by one or more processors (not shown) and one or more memory
architectures (not shown) incorporated into ACI client electronic
devices 28, 30, 32, 34 (respectively). Storage devices 20, 22, 24,
26 may include but are not limited to: hard disk drives; optical
drives; RAID devices; random access memories (RAM); read-only
memories (ROM), and all forms of flash memory storage devices.
Examples of ACI client electronic devices 28, 30, 32, 34 may
include, but are not limited to, personal computing device 28
(e.g., a smart phone, a personal digital assistant, a laptop
computer, a notebook computer, and a desktop computer), audio input
device 30 (e.g., a handheld microphone, a lapel microphone, an
embedded microphone (such as those embedded within eyeglasses,
smart phones, tablet computers and/or watches) and an audio
recording device), display device 32 (e.g., a tablet computer, a
computer monitor, and a smart television), machine vision input
device 34 (e.g., an RGB imaging system, an infrared imaging system,
an ultraviolet imaging system, a laser imaging system, a SONAR
imaging system, a RADAR imaging system, and a thermal imaging
system), a hybrid device (e.g., a single device that includes the
functionality of one or more of the above-references devices; not
shown), an audio rendering device (e.g., a speaker system, a
headphone system, or an earbud system; not shown), various medical
devices (e.g., medical imaging equipment, heart monitoring
machines, body weight scales, body temperature thermometers, and
blood pressure machines; not shown), and a dedicated network device
(not shown).
[0029] Users 36, 38, 40, 42 may access ACI compute system 12
directly through network 14 or through secondary network 18.
Further, ACI compute system 12 may be connected to network 14
through secondary network 18, as illustrated with link line 44.
[0030] The various ACI client electronic devices (e.g., ACI client
electronic devices 28, 30, 32, 34) may be directly or indirectly
coupled to network 14 (or network 18). For example, personal
computing device 28 is shown directly coupled to network 14 via a
hardwired network connection. Further, machine vision input device
34 is shown directly coupled to network 18 via a hardwired network
connection. Audio input device 30 is shown wirelessly coupled to
network 14 via wireless communication channel 46 established
between audio input device 30 and wireless access point (i.e., WAP)
48, which is shown directly coupled to network 14. WAP 48 may be,
for example, an IEEE 802.11a, 802.11b, 802.11g, 802.11n, Wi-Fi,
and/or Bluetooth device that is capable of establishing wireless
communication channel 46 between audio input device 30 and WAP 48.
Display device 32 is shown wirelessly coupled to network 14 via
wireless communication channel 50 established between display
device 32 and WAP 52, which is shown directly coupled to network
14.
[0031] The various ACI client electronic devices (e.g., ACI client
electronic devices 28, 30, 32, 34) may each execute an operating
system, examples of which may include but are not limited to
Microsoft Windows.TM., Apple Macintosh.TM., Redhat Linux.TM., or a
custom operating system, wherein the combination of the various ACI
client electronic devices (e.g., ACI client electronic devices 28,
30, 32, 34) and ACI compute system 12 may form modular ACI system
54.
The Ambient Clinical Intelligence System
[0032] Referring also to FIG. 2, there is shown a simplified
exemplary embodiment of modular ACI system 54 that is configured to
automate clinical documentation. Modular ACI system 54 may include:
machine vision system 100 configured to obtain machine vision
encounter information 102 concerning a patient encounter; audio
recording system 104 configured to obtain audio encounter
information 106 concerning the patient encounter; and a compute
system (e.g., ACI compute system 12) configured to receive machine
vision encounter information 102 and audio encounter information
106 from machine vision system 100 and audio recording system 104
(respectively). Modular ACI system 54 may also include: display
rendering system 108 configured to render visual information 110;
and audio rendering system 112 configured to render audio
information 114, wherein ACI compute system 12 may be configured to
provide visual information 110 and audio information 114 to display
rendering system 108 and audio rendering system 112
(respectively).
[0033] Example of machine vision system 100 may include but are not
limited to: one or more ACI client electronic devices (e.g., ACI
client electronic device 34, examples of which may include but are
not limited to an RGB imaging system, an infrared imaging system, a
ultraviolet imaging system, a laser imaging system, a SONAR imaging
system, a RADAR imaging system, and a thermal imaging system).
Examples of audio recording system 104 may include but are not
limited to: one or more ACI client electronic devices (e.g., ACI
client electronic device 30, examples of which may include but are
not limited to a handheld microphone (e.g., one example of a body
worn microphone), a lapel microphone (e.g., another example of a
body worn microphone), an embedded microphone, such as those
embedded within eyeglasses, smart phones, tablet computers and/or
watches (e.g., another example of a body worn microphone), and an
audio recording device). Examples of display rendering system 108
may include but are not limited to: one or more ACI client
electronic devices (e.g., ACI client electronic device 32, examples
of which may include but are not limited to a tablet computer, a
computer monitor, and a smart television). Examples of audio
rendering system 112 may include but are not limited to: one or
more ACI client electronic devices (e.g., audio rendering device
116, examples of which may include but are not limited to a speaker
system, a headphone system, and an earbud system).
[0034] ACI compute system 12 may be configured to access one or
more datasources 118 (e.g., plurality of individual datasources
120, 122, 124, 126, 128), examples of which may include but are not
limited to one or more of a user profile datasource, a voice print
datasource, a voice characteristics datasource (e.g., for adapting
the ambient speech recognition models), a face print datasource, a
humanoid shape datasource, an utterance identifier datasource, a
wearable token identifier datasource, an interaction identifier
datasource, a medical conditions symptoms datasource, a
prescriptions compatibility datasource, a medical insurance
coverage datasource, a physical events datasource, and a home
healthcare datasource. While in this particular example, five
different examples of datasources 118 are shown, this is for
illustrative purposes only and is not intended to be a limitation
of this disclosure, as other configurations are possible and are
considered to be within the scope of this disclosure.
[0035] As will be discussed below in greater detail, modular ACI
system 54 may be configured to monitor a monitored space (e.g.,
monitored space 130) in a clinical environment, wherein examples of
this clinical environment may include but are not limited to: a
doctor's office, a medical facility, a medical practice, a medical
lab, an urgent care facility, a medical clinic, an emergency room,
an operating room, a hospital, a long term care facility, a
rehabilitation facility, a nursing home, and a hospice facility.
Accordingly, an example of the above-referenced patient encounter
may include but is not limited to a patient visiting one or more of
the above-described clinical environments (e.g., a doctor's office,
a medical facility, a medical practice, a medical lab, an urgent
care facility, a medical clinic, an emergency room, an operating
room, a hospital, a long term care facility, a rehabilitation
facility, a nursing home, and a hospice facility).
[0036] Machine vision system 100 may include a plurality of
discrete machine vision systems when the above-described clinical
environment is larger or a higher level of resolution is desired.
As discussed above, examples of machine vision system 100 may
include but are not limited to: one or more ACI client electronic
devices (e.g., ACI client electronic device 34, examples of which
may include but are not limited to an RGB imaging system, an
infrared imaging system, an ultraviolet imaging system, a laser
imaging system, a SONAR imaging system, a RADAR imaging system, and
a thermal imaging system). Accordingly, machine vision system 100
may include one or more of each of an RGB imaging system, an
infrared imaging systems, an ultraviolet imaging systems, a laser
imaging system, a SONAR imaging system, a RADAR imaging system, and
a thermal imaging system.
[0037] Audio recording system 104 may include a plurality of
discrete audio recording systems when the above-described clinical
environment is larger or a higher level of resolution is desired.
As discussed above, examples of audio recording system 104 may
include but are not limited to: one or more ACI client electronic
devices (e.g., ACI client electronic device 30, examples of which
may include but are not limited to a handheld microphone, a lapel
microphone, an embedded microphone (such as those embedded within
eyeglasses, smart phones, tablet computers and/or watches) and an
audio recording device). Accordingly, audio recording system 104
may include one or more of each of a handheld microphone, a lapel
microphone, an embedded microphone (such as those embedded within
eyeglasses, smart phones, tablet computers and/or watches) and an
audio recording device.
[0038] Display rendering system 108 may include a plurality of
discrete display rendering systems when the above-described
clinical environment is larger or a higher level of resolution is
desired. As discussed above, examples of display rendering system
108 may include but are not limited to: one or more ACI client
electronic devices (e.g., ACI client electronic device 32, examples
of which may include but are not limited to a tablet computer, a
computer monitor, and a smart television). Accordingly, display
rendering system 108 may include one or more of each of a tablet
computer, a computer monitor, and a smart television.
[0039] Audio rendering system 112 may include a plurality of
discrete audio rendering systems when the above-described clinical
environment is larger or a higher level of resolution is desired.
As discussed above, examples of audio rendering system 112 may
include but are not limited to: one or more ACI client electronic
devices (e.g., audio rendering device 116, examples of which may
include but are not limited to a speaker system, a headphone
system, or an earbud system). Accordingly, audio rendering system
112 may include one or more of each of a speaker system, a
headphone system, or an earbud system.
[0040] ACI compute system 12 may include a plurality of discrete
compute systems. As discussed above, ACI compute system 12 may
include various components, examples of which may include but are
not limited to: a personal computer, a server computer, a series of
server computers, a mini computer, a mainframe computer, one or
more Network Attached Storage (NAS) systems, one or more Storage
Area Network (SAN) systems, one or more Platform as a Service
(PaaS) systems, one or more Infrastructure as a Service (IaaS)
systems, one or more Software as a Service (SaaS) systems, a
cloud-based computational system, and a cloud-based storage
platform. Accordingly, ACI compute system 12 may include one or
more of each of a personal computer, a server computer, a series of
server computers, a mini computer, a mainframe computer, one or
more Network Attached Storage (NAS) systems, one or more Storage
Area Network (SAN) systems, one or more Platform as a Service
(PaaS) systems, one or more Infrastructure as a Service (IaaS)
systems, one or more Software as a Service (SaaS) systems, a
cloud-based computational system, and a cloud-based storage
platform.
Microphone Array
[0041] Referring also to FIG. 3, audio recording system 104 may
include microphone array 200 having a plurality of discrete
microphone assemblies. For example, audio recording system 104 may
include a plurality of discrete audio acquisition devices (e.g.,
audio acquisition devices 202, 204, 206, 208, 210, 212, 214, 216,
218) that may form microphone array 200. As will be discussed below
in greater detail, modular ACI system 54 may be configured to form
one or more audio recording beams (e.g., audio recording beams 220,
222, 224) via the discrete audio acquisition devices (e.g., audio
acquisition devices 202, 204, 206, 208, 210, 212, 214, 216, 218)
included within audio recording system 104.
[0042] For example, modular ACI system 54 may be further configured
to steer the one or more audio recording beams (e.g., audio
recording beams 220, 222, 224) toward one or more encounter
participants (e.g., encounter participants 226, 228, 230) of the
above-described patient encounter. Examples of the encounter
participants (e.g., encounter participants 226, 228, 230) may
include but are not limited to: medical professionals (e.g.,
doctors, nurses, physician's assistants, lab technicians, physical
therapists, scribes (e.g., a transcriptionist) and/or staff members
involved in the patient encounter), patients (e.g., people that are
visiting the above-described clinical environments for the patient
encounter), and third parties (e.g., friends of the patient,
relatives of the patient and/or acquaintances of the patient that
are involved in the patient encounter).
[0043] Accordingly, modular ACI system 54 and/or audio recording
system 104 may be configured to utilize one or more of the discrete
audio acquisition devices (e.g., audio acquisition devices 202,
204, 206, 208, 210, 212, 214, 216, 218) to form an audio recording
beam. For example, modular ACI system 54 and/or audio recording
system 104 may be configured to utilize various audio acquisition
devices to form audio recording beam 220, thus enabling the
capturing of audio (e.g., speech) produced by encounter participant
226 (as audio recording beam 220 is pointed to (i.e., directed
toward) encounter participant 226). Additionally, modular ACI
system 54 and/or audio recording system 104 may be configured to
utilize various audio acquisition devices to form audio recording
beam 222, thus enabling the capturing of audio (e.g., speech)
produced by encounter participant 228 (as audio recording beam 222
is pointed to (i.e., directed toward) encounter participant 228).
Additionally, modular ACI system 54 and/or audio recording system
104 may be configured to utilize various audio acquisition devices
to form audio recording beam 224, thus enabling the capturing of
audio (e.g., speech) produced by encounter participant 230 (as
audio recording beam 224 is pointed to (i.e., directed toward)
encounter participant 230). Further, modular ACI system 54 and/or
audio recording system 104 may be configured to utilize
null-steering precoding to cancel interference between speakers
and/or noise.
[0044] As is known in the art, null-steering precoding is a method
of spatial signal processing by which a multiple antenna
transmitter may null multiuser interference signals in wireless
communications, wherein null-steering precoding may mitigate the
impact off background noise and unknown user interference. In
particular, null-steering precoding may be a method of beamforming
for narrowband signals that may compensate for delays of receiving
signals from a specific source at different elements of an antenna
array. In general and to improve performance of the antenna array,
incoming signals may be summed and averaged, wherein certain
signals may be weighted and compensation may be made for signal
delays.
[0045] Machine vision system 100 and audio recording system 104 may
be stand-alone devices (as shown in FIG. 2).
Additionally/alternatively, machine vision system 100 and audio
recording system 104 may be combined into one package to form
mixed-media ACI device 232. For example, mixed-media ACI device 232
may be configured to be mounted to a structure (e.g., a wall, a
ceiling, a beam, a column) within the above-described clinical
environments (e.g., a doctor's office, a medical facility, a
medical practice, a medical lab, an urgent care facility, a medical
clinic, an emergency room, an operating room, a hospital, a long
term care facility, a rehabilitation facility, a nursing home, and
a hospice facility), thus allowing for easy installation of the
same. Further, modular ACI system 54 may be configured to include a
plurality of mixed-media ACI devices (e.g., mixed-media ACI device
232) when the above-described clinical environment is larger or a
higher level of resolution is desired.
[0046] Modular ACI system 54 may be further configured to steer the
one or more audio recording beams (e.g., audio recording beams 220,
222, 224) toward one or more encounter participants (e.g.,
encounter participants 226, 228, 230) of the patient encounter
based, at least in part, upon machine vision encounter information
102. As discussed above, mixed-media ACI device 232 (and machine
vision system 100/audio recording system 104 included therein) may
be configured to monitor one or more encounter participants (e.g.,
encounter participants 226, 228, 230) of a patient encounter.
[0047] Specifically and as will be discussed below in greater
detail, machine vision system 100 (either as a stand-alone system
or as a component of mixed-media ACI device 232) may be configured
to detect humanoid shapes within the above-described clinical
environments (e.g., a doctor's office, a medical facility, a
medical practice, a medical lab, an urgent care facility, a medical
clinic, an emergency room, an operating room, a hospital, a long
term care facility, a rehabilitation facility, a nursing home, and
a hospice facility). And when these humanoid shapes are detected by
machine vision system 100, modular ACI system 54 and/or audio
recording system 104 may be configured to utilize one or more of
the discrete audio acquisition devices (e.g., audio acquisition
devices 202, 204, 206, 208, 210, 212, 214, 216, 218) to form an
audio recording beam (e.g., audio recording beams 220, 222, 224)
that is directed toward each of the detected humanoid shapes (e.g.,
encounter participants 226, 228, 230).
[0048] As discussed above, ACI compute system 12 may be configured
to receive machine vision encounter information 102 and audio
encounter information 106 from machine vision system 100 and audio
recording system 104 (respectively); and may be configured to
provide visual information 110 and audio information 114 to display
rendering system 108 and audio rendering system 112 (respectively).
Depending upon the manner in which modular ACI system 54 (and/or
mixed-media ACI device 232) is configured, ACI compute system 12
may be included within mixed-media ACI device 232 or external to
mixed-media ACI device 232.
The Ambient Clinical Intelligence Process
[0049] As discussed above, ACI compute system 12 may execute all or
a portion of ambient clinical intelligence process 10, wherein the
instruction sets and subroutines of ambient clinical intelligence
process 10 (which may be stored on one or more of e.g., storage
devices 16, 20, 22, 24, 26) may be executed by ACI compute system
12 and/or one or more of ACI client electronic devices 28, 30, 32,
34.
[0050] As discussed above, ambient clinical intelligence process 10
may be configured to automate the collection and processing of
clinical encounter information to generate/store/distribute medical
records. Accordingly and referring also to FIG. 4, ambient clinical
intelligence process 10 may be configured to obtain 300 encounter
information (e.g., machine vision encounter information 102 and/or
audio encounter information 106) of a patient encounter (e.g., a
visit to a doctor's office). Ambient clinical intelligence process
10 may further be configured to process 302 the encounter
information (e.g., machine vision encounter information 102 and/or
audio encounter information 106) to generate an encounter
transcript (e.g., encounter transcript 234), wherein ambient
clinical intelligence process 10 may then process 304 at least a
portion of the encounter transcript (e.g., encounter transcript
234) to populate at least a portion of a medical record (e.g.,
medical record 236) associated with the patient encounter (e.g.,
the visit to the doctor's office). Encounter transcript 234 and/or
medical record 236 may be reviewed by a medical professional
involved with the patient encounter (e.g., a visit to a doctor's
office) to determine the accuracy of the same and/or make
corrections to the same.
[0051] For example, a scribe involved with (or assigned to) the
patient encounter (e.g., a visit to a doctor's office) may review
encounter transcript 234 and/or medical record 236 to confirm that
the same was accurate and/or make corrections to the same. In the
event that corrections are made to encounter transcript 234 and/or
medical record 236, ambient clinical intelligence process 10 may
utilize these corrections for training/tuning purposes (e.g., to
adjust the various profiles associated the participants of the
patient encounter) to enhance the future
accuracy/efficiency/performance of ambient clinical intelligence
process 10.
[0052] Alternatively/additionally, a doctor involved with the
patient encounter (e.g., a visit to a doctor's office) may review
encounter transcript 234 and/or medical record 236 to confirm that
the same was accurate and/or make corrections to the same. In the
event that corrections are made to encounter transcript 234 and/or
medical record 236, ambient clinical intelligence process 10 may
utilize these corrections for training/tuning purposes (e.g., to
adjust the various profiles associated the participants of the
patient encounter) to enhance the future
accuracy/efficiency/performance of ambient clinical intelligence
process 10.
[0053] For example, assume that a patient (e.g., encounter
participant 228) visits a clinical environment (e.g., a doctor's
office) because they do not feel well. They have a headache, fever,
chills, a cough, and some difficulty breathing. In this particular
example, a monitored space (e.g., monitored space 130) within the
clinical environment (e.g., the doctor's office) may be outfitted
with machine vision system 100 configured to obtain machine vision
encounter information 102 concerning the patient encounter (e.g.,
encounter participant 228 visiting the doctor's office) and audio
recording system 104 configured to obtain audio encounter
information 106 concerning the patient encounter (e.g., encounter
participant 228 visiting the doctor's office) via one or more audio
sensors (e.g., audio acquisition devices 202, 204, 206, 208, 210,
212, 214, 216, 218).
[0054] As discussed above, machine vision system 100 may include a
plurality of discrete machine vision systems if the monitored space
(e.g., monitored space 130) within the clinical environment (e.g.,
the doctor's office) is larger or a higher level of resolution is
desired, wherein examples of machine vision system 100 may include
but are not limited to: an RGB imaging system, an infrared imaging
system, an ultraviolet imaging system, a laser imaging system, a
SONAR imaging system, a RADAR imaging system, and a thermal imaging
system. Accordingly and in certain instances/embodiments, machine
vision system 100 may include one or more of each of an RGB imaging
system, an infrared imaging system, an ultraviolet imaging system,
a laser imaging system, a SONAR imaging system, a RADAR imaging
system, and a thermal imaging system positioned throughout
monitored space 130, wherein each of these systems may be
configured to provide data (e.g., machine vision encounter
information 102) to ACI compute system 12 and/or modular ACI system
54.
[0055] As also discussed above, audio recording system 104 may
include a plurality of discrete audio recording systems if the
monitored space (e.g., monitored space 130) within the clinical
environment (e.g., the doctor's office) is larger or a higher level
of resolution is desired, wherein examples of audio recording
system 104 may include but are not limited to: a handheld
microphone, a lapel microphone, an embedded microphone (such as
those embedded within eyeglasses, smart phones, tablet computers
and/or watches) and an audio recording device. Accordingly and in
certain instances/embodiments, audio recording system 104 may
include one or more of each of a handheld microphone, a lapel
microphone, an embedded microphone (such as those embedded within
eyeglasses, smart phones, tablet computers and/or watches) and an
audio recording device positioned throughout monitored space 130,
wherein each of these microphones/devices may be configured to
provide data (e.g., audio encounter information 106) to ACI compute
system 12 and/or modular ACI system 54.
[0056] Since machine vision system 100 and audio recording system
104 may be positioned throughout monitored space 130, all of the
interactions between medical professionals (e.g., encounter
participant 226), patients (e.g., encounter participant 228) and
third parties (e.g., encounter participant 230) that occur during
the patient encounter (e.g., encounter participant 228 visiting the
doctor's office) within the monitored space (e.g., monitored space
130) of the clinical environment (e.g., the doctor's office) may be
monitored/recorded/processed. Accordingly, a patient "check-in"
area within monitored space 130 may be monitored to obtain
encounter information (e.g., machine vision encounter information
102 and/or audio encounter information 106) during this pre-visit
portion of the patient encounter (e.g., encounter participant 228
visiting the doctor's office). Further, various rooms within
monitored space 130 may be monitored to obtain encounter
information (e.g., machine vision encounter information 102 and/or
audio encounter information 106) during these various portions of
the patient encounter (e.g., while meeting with the doctor, while
vital signs and statistics are obtained, and while imaging is
performed). Further, a patient "check-out" area within monitored
space 130 may be monitored to obtain encounter information (e.g.,
machine vision encounter information 102 and/or audio encounter
information 106) during this post-visit portion of the patient
encounter (e.g., encounter participant 228 visiting the doctor's
office). Additionally and via machine vision encounter information
102, visual speech recognition (via visual lip reading
functionality) may be utilized by ambient clinical intelligence
process 10 to further effectuate the gathering of audio encounter
information 106.
[0057] Accordingly and when obtaining 300 encounter information
(e.g., machine vision encounter information 102 and/or audio
encounter information 106), ambient clinical intelligence process
10 may: obtain 306 encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
from a medical professional (e.g., encounter participant 226);
obtain 308 encounter information (e.g., machine vision encounter
information 102 and/or audio encounter information 106) from a
patient (e.g., encounter participant 228); and/or obtain 310
encounter information (e.g., machine vision encounter information
102 and/or audio encounter information 106) from a third party
(e.g., encounter participant 230). Further and when obtaining 300
encounter information (e.g., machine vision encounter information
102 and/or audio encounter information 106), ambient clinical
intelligence process 10 may obtain 300 the encounter information
(e.g., machine vision encounter information 102 and/or audio
encounter information 106) from previous (related or unrelated)
patient encounters. For example, if the current patient encounter
is actually the third visit that the patient is making concerning
e.g., shortness of breath, the encounter information from the
previous two visits (i.e., the previous two patient encounters) may
be highly-related and may be obtained 300 by ambient clinical
intelligence process 10.
[0058] When ambient clinical intelligence process 10 obtains 300
the encounter information, ambient clinical intelligence process 10
may utilize 312 a virtual assistant (e.g., virtual assistant 238)
to prompt the patient (e.g., encounter participant 228) to provide
at least a portion of the encounter information (e.g., machine
vision encounter information 102 and/or audio encounter information
106) during a pre-visit portion (e.g., a patient intake portion) of
the patient encounter (e.g., encounter participant 228 visiting the
doctor's office).
[0059] Further and when ambient clinical intelligence process 10
obtains 300 encounter information, ambient clinical intelligence
process 10 may utilize 314 a virtual assistant (e.g., virtual
assistant 238) to prompt the patient (e.g., encounter participant
228) to provide at least a portion of the encounter information
(e.g., machine vision encounter information 102 and/or audio
encounter information 106) during a post-visit portion (e.g., a
patient follow-up portion) of the patient encounter (e.g.,
encounter participant 228 visiting the doctor's office).
Automated Transcript Generation
[0060] Ambient clinical intelligence process 10 may be configured
to process the encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
to generate encounter transcript 234 that may he automatically
formatted and punctuated.
[0061] Accordingly and referring also to FIG. 5, ambient clinical
intelligence process 10 may be configured to obtain 300 encounter
information (e.g., machine vision encounter information 102 and/or
audio encounter information 106) of a patient encounter (e.g., a
visit to a doctor's office).
[0062] Ambient clinical intelligence process 10 may process 350 the
encounter information (e.g., machine vision encounter information
102 and/or audio encounter information 106) to: associate a first
portion of the encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
with a first encounter participant, and associate at least a second
portion of the encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
with at least a second encounter participant.
[0063] As discussed above, modular ACI system 54 may be configured
to form one or more audio recording beams (e.g., audio recording
beams 220, 222, 224) via the discrete audio acquisition devices
(e.g., discrete audio acquisition devices 202, 204, 206, 208, 210,
212, 214, 216, 218) included within audio recording system 104,
wherein modular ACI system 54 may be further configured to steer
the one or more audio recording beams (e.g., audio recording beams
220, 222, 224) toward one or more encounter participants (e.g.,
encounter participants 226, 228, 230) of the above-described
patient encounter.
[0064] Accordingly and continuing with the above-stated example,
modular ACI system 54 may steer audio recording beam 220 toward
encounter participant 226, may steer audio recording beam 222
toward encounter participant 228, and may steer audio recording
beam 224 toward encounter participant 230. Accordingly and due to
the directionality of audio recording beams 220, 222, 224, audio
encounter information 106 may include three components, namely
audio encounter information 106A (which is obtained via audio
recording beam 220), audio encounter information 106B (which is
obtained via audio recording beam 222) and audio encounter
information 106C (which is obtained via audio recording beam
220).
[0065] Further and as discussed above, ACI compute system 12 may be
configured to access one or more datasources 118 (e.g., plurality
of individual datasources 120, 122, 124, 126, 128), examples of
which may include but are not limited to one or more of a user
profile datasource, a voice print datasource, a voice
characteristics datasource (e.g., for adapting the automated speech
recognition models), a face print datasource, a humanoid shape
datasource, an utterance identifier datasource, a wearable token
identifier datasource, an interaction identifier datasource, a
medical conditions symptoms datasource, a prescriptions
compatibility datasource, a medical insurance coverage datasource,
a physical events datasource, and a home healthcare datasource.
[0066] Accordingly, ambient clinical intelligence process 10 may
process 350 the encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
to: associate a first portion (e.g., encounter information 106A) of
the encounter information (e.g., audio encounter information 106)
with a first encounter participant (e.g., encounter participant
226), and associate at least a second portion (e.g., encounter
information 106B, 106C) of the encounter information (e.g., audio
encounter information 106) with at least a second encounter
participant (e.g., encounter participants 228, 230;
respectively).
[0067] Further and when processing 350 the encounter information
(e.g., audio encounter information 106A, 106B, 106C), ambient
clinical intelligence process 10 may compare each of audio
encounter information 106A, 106B, 106C to the voice prints defined
within the above-referenced voice print datasource so that the
identity of encounter participants 226, 228, 230 (respectively) may
be determined. Accordingly, if the voice print datasource includes
a voice print that corresponds to one or more of the voice of
encounter participant 226 (as heard within audio encounter
information 106A), the voice of encounter participant 228 (as heard
within audio encounter information 106B) or the voice of encounter
participant 230 (as heard within audio encounter information 106C),
the identity of one or more of encounter participants 226, 228, 230
may be defined. And in the event that a voice heard within one or
more of audio encounter information 106A, audio encounter
information 106B or audio encounter information 106C is
unidentifiable, that one or more particular encounter participant
may be defined as "Unknown Participant".
[0068] Once the voices of encounter participants 226, 228, 230 are
processed 350, ambient clinical intelligence process 10 may
generate 302 an encounter transcript (e.g., encounter transcript
234) based, at least in part, upon the first portion of the
encounter information (e.g., audio encounter information 106A) and
the at least a second portion of the encounter information (e.g.,
audio encounter information 106B. 106C).
Automated Role Assignment
[0069] Ambient clinical intelligence process 10 may be configured
to automatically define roles for the encounter participants (e.g.,
encounter participants 226, 228, 230) in the patient encounter
(e.g., a visit to a doctor's office).
[0070] Accordingly and referring also to FIG. 6, ambient clinical
intelligence process 10 may be configured to obtain 300 encounter
information (e.g., machine vision encounter information 102 and/or
audio encounter information 106) of a patient encounter (e.g., a
visit to a doctor's office).
[0071] Ambient clinical intelligence process 10 may then process
400 the encounter information (e.g., machine vision encounter
information 102 and/or audio encounter information 106) to
associate a first portion of the encounter information with a first
encounter participant (e.g., encounter participant 226) and assign
402 a first role to the first encounter participant (e.g.,
encounter participant 226).
[0072] When processing 400 the encounter information (e.g., machine
vision encounter information 102 and/or audio encounter information
106) to associate the first portion of the encounter information
with the first encounter participant (e.g., encounter participant
226), ambient clinical intelligence process 10 may process 404 the
encounter information (e.g., machine vision encounter information
102 and/or audio encounter information 106) to associate a first
portion of the audio encounter information (e.g., audio encounter
information 106A) with the first encounter participant (e.g.,
encounter participant 226).
[0073] Specifically and when processing 404 the encounter
information (e.g., machine vision encounter information 102 and/or
audio encounter information 106) to associate the first portion of
the audio encounter information (e.g., audio encounter information
106A) with the first encounter participant (e.g., encounter
participant 226), ambient clinical intelligence process 10 may
compare 406 one or more voice prints (defined within voice print
datasource) to one or more voices defined within the first portion
of the audio encounter information (e.g., audio encounter
information 106A); and may compare 408 one or more utterance
identifiers (defined within utterance datasource) to one or more
utterances defined within the first portion of the audio encounter
information (e.g., audio encounter information 106A); wherein
comparisons 406, 408 may allow ambient clinical intelligence
process 10 to assign 402 a first role to the first encounter
participant (e.g., encounter participant 226). For example, if the
identity of encounter participant 226 can be defined via voice
prints, a role for encounter participant 226 may be assigned 402 if
that identity defined is associated with a role (e.g., the identity
defined for encounter participant 226 is Doctor Susan Jones).
Further, if an utterance made by encounter participant 226 is "I am
Doctor Susan Jones", this utterance may allow a role for encounter
participant 226 to be assigned 402.
[0074] When processing 400 the encounter information (e.g., machine
vision encounter information 102 and/or audio encounter information
106) to associate the first portion of the encounter information
with the first encounter participant (e.g., encounter participant
226), ambient clinical intelligence process 10 may process 410 the
encounter information (e.g., machine vision encounter information
102 and/or audio encounter information 106) to associate a first
portion of the machine vision encounter information (e.g., machine
vision encounter information 102A) with the first encounter
participant (e.g., encounter participant 226).
[0075] Specifically and when processing 410 the encounter
information (e.g., machine vision encounter information 102 and/or
audio encounter information 106) to associate the first portion of
the machine vision encounter information (e.g., machine vision
encounter information 102A) with the first encounter participant
(e.g., encounter participant 226), ambient clinical intelligence
process 10 may compare 412 one or more face prints (defined within
face print datasource) to one or more faces defined within the
first portion of the machine vision encounter information (e.g.,
machine vision encounter information 102A); compare 414 one or more
wearable token identifiers (defined within wearable token
identifier datasource) to one or more wearable tokens defined
within the first portion of the machine vision encounter
information (e.g., machine vision encounter information 102A); and
compare 416 one or more interaction identifiers (defined within
interaction identifier datasource) to one or more humanoid
interactions defined within the first portion of the machine vision
encounter information (e.g., machine vision encounter information
102A); wherein comparisons 412, 414, 416 may allow ambient clinical
intelligence process 10 to assign 402 a first role to the first
encounter participant (e.g., encounter participant 226). For
example, if the identity of encounter participant 226 can be
defined via face prints, a role for encounter participant 226 may
be assigned 402 if that identity defined is associated with a role
(e.g., the identity defined for encounter participant 226 is Doctor
Susan Jones). Further, if a wearable token worn by encounter
participant 226 can be identified as a wearable token assigned to
Doctor Susan Jones, a role for encounter participant 226 may be
assigned 402. Additionally, if an interaction made by encounter
participant 226 corresponds to the type of interaction that is made
by a doctor, the existence of this interaction may allow a role for
encounter participant 226 to be assigned 402.
[0076] Examples of such wearable tokens may include but are not
limited to wearable devices that may be worn by the medical
professionals when they are within monitored space 130 (or after
they leave monitored space 130). For example, these wearable tokens
may be worn by medical professionals when e.g., they are moving
between monitored rooms within monitored space 130, travelling to
and/or from monitored space 130, and/or outside of monitored space
130 (e.g., at home).
[0077] Additionally, ambient clinical intelligence process 10 may
process 418 the encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
to associate at least a second portion of the encounter information
with at least a second encounter participant; and may assign 420 at
least a second role to the at least a second encounter
participant.
[0078] Specifically, ambient clinical intelligence process 10 may
process 418 the encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
to associate at least a second portion of the encounter information
with at least a second encounter participant. For example, ambient
clinical intelligence process 10 may process 418 the encounter
information (e.g., machine vision encounter information 102 and/or
audio encounter information 106) to associate audio encounter
information 106B and machine vision encounter information 102B with
encounter participant 228 and may associate audio encounter
information 106C and machine vision encounter information 102C with
encounter participant 230.
[0079] Further, ambient clinical intelligence process 10 may assign
420 at least a second role to the at least a second encounter
participant. For example, ambient clinical intelligence process 10
may assign 420 a role to encounter participants 228, 230.
Automated Movement Tracking
[0080] Ambient clinical intelligence process 10 may be configured
to track the movement and/or interaction of humanoid shapes within
the monitored space (e.g., monitored space 130) during the patient
encounter (e.g., a visit to a doctor's office) so that e.g., the
ambient clinical intelligence process 10 knows when encounter
participants (e.g., one or more of encounter participants 226, 228,
230) enter, exit or cross paths within monitored space 130.
[0081] Accordingly and referring also to FIG. 7, ambient clinical
intelligence process 10 may process 450 the machine vision
encounter information (e.g., machine vision encounter information
102) to identify one or more humanoid shapes. As discussed above,
examples of machine vision system 100 generally (and ACI client
electronic device 34 specifically) may include but are not limited
to one or more of an RGB imaging system, an infrared imaging
system, an ultraviolet imaging system, a laser imaging system, a
SONAR imaging system, a RADAR imaging system, and a thermal imaging
system).
[0082] When ACI client electronic device 34 includes a visible
light imaging system (e.g., an RGB imaging system), ACI client
electronic device 34 may be configured to monitor various objects
within monitored space 130 by recording motion video in the visible
light spectrum of these various objects. When ACI client electronic
device 34 includes an invisible light imaging systems (e.g., a
laser imaging system, an infrared imaging system and/or an
ultraviolet imaging system), ACI client electronic device 34 may be
configured to monitor various objects within monitored space 130 by
recording motion video in the invisible light spectrum of these
various objects. When ACI client electronic device 34 includes an
X-ray imaging system, ACI client electronic device 34 may be
configured to monitor various objects within monitored space 130 by
recording energy in the X-ray spectrum of these various objects.
When ACI client electronic device 34 includes a SONAR imaging
system, ACI client electronic device 34 may be configured to
monitor various objects within monitored space 130 by transmitting
soundwaves that may be reflected off of these various objects. When
ACI client electronic device 34 includes a RADAR imaging system,
ACI client electronic device 34 may be configured to monitor
various objects within monitored space 130 by transmitting radio
waves that may be reflected off of these various objects. When ACI
client electronic device 34 includes a thermal imaging system, ACI
client electronic device 34 may be configured to monitor various
objects within monitored space 130 by tracking the thermal energy
of these various objects.
[0083] As discussed above, ACI compute system 12 may be configured
to access one or more datasources 118 (e.g., plurality of
individual datasources 120, 122, 124, 126, 128), wherein examples
of which may include but are not limited to one or more of a user
profile datasource, a voice print datasource, a voice
characteristics datasource (e.g., for adapting the automated speech
recognition models), a face print datasource, a humanoid shape
datasource, an utterance identifier datasource, a wearable token
identifier datasource, an interaction identifier datasource, a
medical conditions symptoms datasource, a prescriptions
compatibility datasource, a medical insurance coverage datasource,
a physical events datasource, and a home healthcare datasource.
[0084] Accordingly and when processing 450 the machine vision
encounter information (e.g., machine vision encounter information
102) to identify one or more humanoid shapes, ambient clinical
intelligence process 10 may be configured to compare the humanoid
shapes defined within one or more datasources 118 to potential
humanoid shapes within the machine vision encounter information
(e.g., machine vision encounter information 102).
[0085] When processing 450 the machine vision encounter information
(e.g., machine vision encounter information 102) to identify one or
more humanoid shapes, ambient clinical intelligence process 10 may
track 452 the movement of the one or more humanoid shapes within
the monitored space (e.g., monitored space 130). For example and
when tracking 452 the movement of the one or more humanoid shapes
within monitored space 130, ambient clinical intelligence process
10 may add 454 a new humanoid shape to the one or more humanoid
shapes when the new humanoid shape enters the monitored space
(e.g., monitored space 130) and/or may remove 456 an existing
humanoid shape from the one or more humanoid shapes when the
existing humanoid shape leaves the monitored space (e.g., monitored
space 130).
[0086] For example, assume that a lab technician (e.g., encounter
participant 242) temporarily enters monitored space 130 to chat
with encounter participant 230. Accordingly, ambient clinical
intelligence process 10 may add 454 encounter participant 242 to
the one or more humanoid shapes being tracked 452 when the new
humanoid shape (i.e., encounter participant 242) enters monitored
space 130. Further, assume that the lab technician (e.g., encounter
participant 242) leaves monitored space 130 after chatting with
encounter participant 230. Therefore, ambient clinical intelligence
process 10 may remove 456 encounter participant 242 from the one or
more humanoid shapes being tracked 452 when the humanoid shape
(i.e., encounter participant 242) leaves monitored space 130.
[0087] Also and when tracking 452 the movement of the one or more
humanoid shapes within monitored space 130, ambient clinical
intelligence process 10 may monitor the trajectories of the various
humanoid shapes within monitored space 130. Accordingly, assume
that when leaving monitored space 130, encounter participant 242
walks in front of (or behind) encounter participant 226. As ambient
clinical intelligence process 10 is monitoring the trajectories of
(in this example) encounter participant 242 (who is e.g., moving
from left to right) and encounter participant 226 (who is e.g.,
stationary), when encounter participant 242 passes in front of (or
behind) encounter participant 226, the identities of these two
humanoid shapes may not be confused by ambient clinical
intelligence process 10.
[0088] Ambient clinical intelligence process 10 may be configured
to obtain 300 the encounter information of the patient encounter
(e.g., a visit to a doctor's office), which may include machine
vision encounter information 102 (in the manner described above)
and/or audio encounter information 106.
[0089] Ambient clinical intelligence process 10 may steer 458 one
or more audio recording beams (e.g., audio recording beams 220,
222, 224) toward the one or more humanoid shapes (e.g., encounter
participants 226, 228, 230) to capture audio encounter information
(e.g., audio encounter information 106), wherein audio encounter
information 106 may be included within the encounter information
(e.g., machine vision encounter information 102 and/or audio
encounter information 106).
[0090] Specifically and as discussed above, ambient clinical
intelligence process 10 (via modular ACI system 54 and/or audio
recording system 104) may utilize one or more of the discrete audio
acquisition devices (e.g., audio acquisition devices 202, 204, 206,
208, 210, 212, 214, 216, 218) to form an audio recording beam. For
example, modular ACI system 54 and/or audio recording system 104
may be configured to utilize various audio acquisition devices to
form audio recording beam 220, thus enabling the capturing of audio
(e.g., speech) produced by encounter participant 226 (as audio
recording beam 220 is pointed to (i.e., directed toward) encounter
participant 226). Additionally, modular ACI system 54 and/or audio
recording system 104 may be configured to utilize various audio
acquisition devices to form audio recording beam 222, thus enabling
the capturing of audio (e.g., speech) produced by encounter
participant 228 (as audio recording beam 222 is pointed to (i.e.,
directed toward) encounter participant 228). Additionally, modular
ACI system 54 and/or audio recording system 104 may be configured
to utilize various audio acquisition devices to form audio
recording beam 224, thus enabling the capturing of audio (e.g.,
speech) produced by encounter participant 230 (as audio recording
beam 224 is pointed to (i.e., directed toward) encounter
participant 230).
[0091] Once obtained, ambient clinical intelligence process 10 may
process 302 the encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
to generate encounter transcript 234 and may process 304 at least a
portion of encounter transcript 234 to populate at least a portion
of a medical record (e.g., medical record 236) associated with the
patient encounter (e.g., a visit to a doctor's office).
Physical Event Detection:
[0092] As discussed above and as shown in FIG. 2, modular ACI
system 54 may be configured to automate clinical documentation,
wherein modular ACI system 54 may include: machine vision system
100 configured to obtain machine vision encounter information 102
concerning a patient encounter; audio recording system 104
configured to obtain audio encounter information 106 concerning the
patient encounter; and a compute system (e.g., ACI compute system
12) configured to receive machine vision encounter information 102
and audio encounter information 106 from machine vision system 100
and audio recording system 104 (respectively).
[0093] Machine vision system 100 may include but are not limited
to: one or more ACI client electronic devices (e.g., ACI client
electronic device 34, examples of which may include but are not
limited to an RGB imaging system, an infrared imaging system, a
ultraviolet imaging system, a laser imaging system, a SONAR imaging
system, a RADAR imaging system, and a thermal imaging system).
[0094] Audio recording system 104 may include but are not limited
to: one or more ACI client electronic devices (e.g., ACI client
electronic device 30, examples of which may include but are not
limited to a handheld microphone (e.g., one example of a body worn
microphone), a lapel microphone (e.g., another example of a body
worn microphone), an embedded microphone, such as those embedded
within eyeglasses, smart phones, tablet computers and/or watches
(e.g., another example of a body worn microphone), and an audio
recording device).
[0095] As discussed above and referring also to FIG. 8, ambient
clinical intelligence process 10 may be configured to obtain 300
encounter information (e.g., machine vision encounter information
102 and/or audio encounter information 106) during a patient
encounter (e.g., a visit to a doctor's office). When obtaining 300
encounter information during the patient encounter (e.g., a visit
to a doctor's office), ambient clinical intelligence process 10 may
utilize 500 a machine vision system (e.g., machine vision system
100) to obtain 300 machine vision encounter information (e.g.,
machine vision encounter information 102) during the patient
encounter (e.g., a visit to a doctor's office).
[0096] Once obtained 300, ambient clinical intelligence process 10
may process 502 the encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
to detect the execution of a physical event during the patient
encounter (e.g., a visit to a doctor's office), thus defining a
detected physical event (e.g., detected physical event 132).
[0097] The detected physical event (e.g., detected physical event
132) may be any event that occurs during the patient encounter that
is not adequately discernable via only audio encounter information
106.
[0098] Some detected physical events (e.g., detected physical event
132) may not include a verbal component, examples of which may
include but are not limited to: [0099] a patient (e.g., encounter
participant 228) limping into the monitored space (e.g., monitored
space 130); [0100] a patient (e.g., encounter participant 228)
rubbing their head; [0101] a patient (e.g., encounter participant
228) pointing to a portion of their body to indicate the location
of their pain to a medical professional (e.g., encounter
participant 226); [0102] a patient (e.g., encounter participant
228) performing a range-of-motion test for a medical professional
(e.g., encounter participant 226); [0103] a medical professional
(e.g., encounter participant 226) examining the lymph nodes of a
patient (e.g., encounter participant 228); and [0104] a medical
professional (e.g., encounter participant 226) palpitating the
abdomen of a patient (e.g., encounter participant 228).
[0105] However, some detected physical events (e.g., detected
physical event 132) may be associable with a verbal component,
examples of which may include but are not limited to: [0106] a
patient (e.g., encounter participant 228) pointing to a portion of
their body to indicate the location of their pain in response to a
physician (e.g., encounter participant 226) asking them "Where does
it hurt?"; [0107] a patient (e.g., encounter participant 228)
performing a range-of-motion test for a physician (e.g., encounter
participant 226) in response to the physician (e.g., encounter
participant 226) instructing them to "Hold your arms out straight
from your side and touch them above your head"; and [0108] a
patient (e.g., encounter participant 228) attempting to touch their
toes in response to a physician (e.g., encounter participant 226)
asking them to "Please try to touch your toes without bending your
knees".
[0109] Further still, some detected physical events (e.g., detected
physical event 132) may include the use of a physical device (e.g.,
when a medical professional uses a medical device), examples of
which may include but are not limited to: [0110] a medical
professional (e.g., encounter participant 226) looking into the
mouth of patient (e.g., encounter participant 228) using a handheld
light; [0111] a medical professional (e.g., encounter participant
226) listening to the respiratory function of a patient (e.g.,
encounter participant 228) using a stethoscope; [0112] a medical
professional (e.g., encounter participant 226) listening to the
heart of a patient (e.g., encounter participant 228) using a
stethoscope; and [0113] a medical professional (e.g., encounter
participant 226) taking the blood pressure of a patient (e.g.,
encounter participant 228) using a blood pressure cuff, meter and
stethoscope.
[0114] Once a physical event (e.g., detected physical event 132) is
detected, ambient clinical intelligence process 10 may derive 504
information for the detected physical event (e.g., detected
physical event 132). The information derived for the detected
physical event may include: machine vision encounter information;
and audio encounter information. As discussed above, some detected
physical events (e.g., detected physical event 132) may be
associable with a verbal component. Accordingly and in such a
situation, the information derived for the detected physical event
may include both machine vision encounter information and audio
encounter information. As discussed above, ACI compute system 12
may be configured to access one or more datasources 118 (e.g.,
plurality of individual datasources 120, 122, 124, 126, 128),
examples of which may include but are not limited to one or more of
a user profile datasource, a voice print datasource, a voice
characteristics datasource (e.g., for adapting the automated speech
recognition models), a face print datasource, a humanoid shape
datasource, an utterance identifier datasource, a wearable token
identifier datasource, an interaction identifier datasource, a
medical conditions symptoms datasource, a prescriptions
compatibility datasource, a medical insurance coverage datasource,
a physical events datasource, and a home healthcare datasource.
[0115] Accordingly, such a physical events datasource may be
configured to define one or more of the above-described physical
events, wherein ambient clinical intelligence process 10 may be
configured to access such a physical events datasource when
processing 502 the encounter information (e.g., machine vision
encounter information 102 and/or audio encounter information 106)
to detect the execution of a physical event during the patient
encounter (e.g., a visit to a doctor's office) and derive 504
information for the detected physical event (e.g., detected
physical event 132). For example, ambient clinical intelligence
process 10 may compare the encounter information (e.g., machine
vision encounter information 102 and/or audio encounter information
106) to the physical events defined within such a physical events
datasource to detect the execution of a physical event during the
patient encounter (e.g., a visit to a doctor's office) and derive
504 information for the detected physical event (e.g., detected
physical event 132).
[0116] When deriving 504 information for the detected physical
event (e.g., detected physical event 132), ambient clinical
intelligence process 10: may generate 506 a text-based description
of the detected physical event (e.g., detected physical event 132);
and may annotate 508 a medical record to include the text-based
description of the detected physical event (e.g., detected physical
event 132).
[0117] For example, in a situation where a patient (e.g., encounter
participant 228) pointed to their left knee to indicate the
location of their pain to a medical professional (e.g., encounter
participant 226), ambient clinical intelligence process 10: may
generate 506 a text-based description (e.g., "Patient pointed to
left knee with right hand") of the detected physical event (e.g.,
detected physical event 132); and may annotate 508 a medical record
(e.g., medical record 236) to include the text-based description
(e.g., "Patient pointed to left knee with right hand") of the
detected physical event (e.g., detected physical event 132).
[0118] Through the use of ambient clinical intelligence process 10,
ambiguous words (e.g., this, that, here, there, those) may be
disambiguated, thus allowing "Does it hurt here?" to have an
understandable meaning, For example, detected physical event 132
may be a physician (e.g., encounter participant 226) pointing to
the left knee of the patient (e.g., encounter participant 228)
while asking "Does it hurt here?". Naturally, there must be
temporal alignment for ambient clinical intelligence process 10 to
utilize a detected physical event (e.g., the physician pointing to
the left knee of the patient) to disambiguate "Does it hurt here?"
For example, if there is a 20 minute gap between these two events,
one does not add any clarity to the other; while (conversely) if
these two events occur contemporaneously, one does add clarity to
the other.
[0119] Further, in the situation where a patient (e.g., encounter
participant 228) performed a range-of-motion test for a physician
(e.g., encounter participant 226) in response to the request of a
physician (e.g., encounter participant 226), ambient clinical
intelligence process 10: may generate 506 a text-based description
(e.g., "Patient performed range-of-motion test. Patient displayed
an 88 degree range of motion in their right shoulder and a 73
degree range of motion in their left shoulder."); and may annotate
508 a medical record (e.g., medical record 236) to include the
text-based description (e.g., "Patient performed range-of-motion
test. Patient displayed a 88 degree range of motion in their right
shoulder and a 73 degree range of motion in their left shoulder.")
of the detected physical event (e.g., detected physical event
132).
[0120] For information that has values associated with it (such as
the above-described range-of-motion test), this value-based
information (e.g., 88 degree range of motion in right shoulder and
73 degree range of motion in left shoulder) may be compared to
previous values of the same information so that the status of the
patient (e.g., encounter participant 228) may be monitored over a
period of time.
[0121] When deriving 504 information for the detected physical
event (e.g., detected physical event 132), ambient clinical
intelligence process 10 may: associate 510 the detected physical
event (e.g., detected physical event 132) with a defined procedure;
and memorialize 512 the execution of the defined procedure.
[0122] For example, if a patient (e.g., encounter participant 228)
makes an appointment to see a medical professional (e.g., encounter
participant 226) because they are not feeling well, the medical
professional (e.g., encounter participant 226) may perform a
"review of symptoms" procedure that may require the medical
professional (e.g., encounter participant 226) to perform several
defined procedures. For example: the medical professional (e.g.,
encounter participant 226) may (among other things): [0123] examine
the lymph nodes of the patient (e.g., encounter participant 228);
[0124] palpitate the abdomen of the patient (e.g., encounter
participant 228); [0125] look into the mouth of the patient (e.g.,
encounter participant 228); [0126] listen to the respiratory
function of the patient (e.g., encounter participant 228); [0127]
listen to the heart of the patient (e.g., encounter participant
228); and [0128] take a blood pressure reading of the patient
(e.g., encounter participant 228).
[0129] Oftentimes, medical best practices (or medical insurance
providers) require that a defined number of procedures be performed
whenever a patient (e.g., encounter participant 228) visits a
medical professional (e.g., encounter participant 226), wherein the
performance of these procedures may be required to e.g., be paid by
the medical insurance provider, avoid malpractice claims, adhere to
the requirements of their employer, etc.
[0130] Accordingly and when deriving 504 information for the
detected physical event (e.g., detected physical event 132),
ambient clinical intelligence process 10 may associate 510 the
detected physical event (e.g., detected physical event 132) with a
defined procedure (e.g., examining the lymph nodes, palpitating the
abdomen, looking into the mouth, listening to the respiratory
function, listening to the heart, or taking a blood pressure
reading). Ambient clinical intelligence process 10 may then
memorialize 512 the execution of the defined procedure by e.g.,
annotating 508 a medical record (e.g., medical record 236).
[0131] Further and when deriving 504 information for the detected
physical event (e.g., detected physical event 132), ambient
clinical intelligence process 10 may: determine 514 the
appropriateness of the detected physical event (e.g., detected
physical event 132) to e.g., determine the appropriateness of the
interaction between the patient (e.g., encounter participant 228)
and the medical professional (e.g., encounter participant 226).
[0132] For example and when determining 514 the appropriateness of
the detected physical event (e.g., detected physical event 132),
ambient clinical intelligence process 10: [0133] may determine 516
whether the detected physical event (e.g., detected physical event
132) violates any professional rules; [0134] may determine 518
whether the detected physical event (e.g., detected physical event
132) violates any civil rules; and/or [0135] may determine 520
whether the detected physical event (e.g., detected physical event
132) violates any criminal laws.
[0136] For example, did the detected physical event (e.g., detected
physical event 132) indicate that the medical professional (e.g.,
encounter participant 226) inappropriately touched the patient
(e.g., encounter participant 228). If so, did that inappropriate
touching violate any professional rules, civil rules or criminal
rules?
General:
[0137] As will be appreciated by one skilled in the art, the
present disclosure may be embodied as a method, a system, or a
computer program product. Accordingly, the present disclosure may
take the form of an entirely hardware embodiment, an entirely
software embodiment (including firmware, resident software,
micro-code, etc.) or an embodiment combining software and hardware
aspects that may all generally be referred to herein as a
"circuit," "module" or "system." Furthermore, the present
disclosure may take the form of a computer program product on a
computer-usable storage medium having computer-usable program code
embodied in the medium.
[0138] Any suitable computer usable or computer readable medium may
be utilized. The computer-usable or computer-readable medium may
be, for example but not limited to, an electronic, magnetic,
optical, electromagnetic, infrared, or semiconductor system,
apparatus, device, or propagation medium. More specific examples (a
non-exhaustive list) of the computer-readable medium may include
the following: an electrical connection having one or more wires, a
portable computer diskette, a hard disk, a random access memory
(RAM), a read-only memory (ROM), an erasable programmable read-only
memory (EPROM or Flash memory), an optical fiber, a portable
compact disc read-only memory (CD-ROM), an optical storage device,
a transmission media such as those supporting the Internet or an
intranet, or a magnetic storage device. The computer-usable or
computer-readable medium may also be paper or another suitable
medium upon which the program is printed, as the program can be
electronically captured, via, for instance, optical scanning of the
paper or other medium, then compiled, interpreted, or otherwise
processed in a suitable manner, if necessary, and then stored in a
computer memory. In the context of this document, a computer-usable
or computer-readable medium may be any medium that can contain,
store, communicate, propagate, or transport the program for use by
or in connection with the instruction execution system, apparatus,
or device. The computer-usable medium may include a propagated data
signal with the computer-usable program code embodied therewith,
either in baseband or as part of a carrier wave. The computer
usable program code may be transmitted using any appropriate
medium, including but not limited to the Internet, wireline,
optical fiber cable, RF, etc.
[0139] Computer program code for carrying out operations of the
present disclosure may be written in an object oriented programming
language such as Java, Smalltalk, C++ or the like. However, the
computer program code for carrying out operations of the present
disclosure may also be written in conventional procedural
programming languages, such as the "C" programming language or
similar programming languages. The program code may execute
entirely on the user's computer, partly on the user's computer, as
a stand-alone software package, partly on the user's computer and
partly on a remote computer or entirely on the remote computer or
server. In the latter scenario, the remote computer may be
connected to the user's computer through a local area network/a
wide area network/the Internet (e.g., network 14).
[0140] The present disclosure is described with reference to
flowchart illustrations and/or block diagrams of methods, apparatus
(systems) and computer program products according to embodiments of
the disclosure. It will be understood that each block of the
flowchart illustrations and/or block diagrams, and combinations of
blocks in the flowchart illustrations and/or block diagrams, may be
implemented by computer program instructions. These computer
program instructions may be provided to a processor of a general
purpose computer/special purpose computer/other programmable data
processing apparatus, such that the instructions, which execute via
the processor of the computer or other programmable data processing
apparatus, create means for implementing the functions/acts
specified in the flowchart and/or block diagram block or
blocks.
[0141] These computer program instructions may also be stored in a
computer-readable memory that may direct a computer or other
programmable data processing apparatus to function in a particular
manner, such that the instructions stored in the computer-readable
memory produce an article of manufacture including instruction
means which implement the function/act specified in the flowchart
and/or block diagram block or blocks.
[0142] The computer program instructions may also be loaded onto a
computer or other programmable data processing apparatus to cause a
series of operational steps to be performed on the computer or
other programmable apparatus to produce a computer implemented
process such that the instructions which execute on the computer or
other programmable apparatus provide steps for implementing the
functions/acts specified in the flowchart and/or block diagram
block or blocks.
[0143] The flowcharts and block diagrams in the figures may
illustrate the architecture, functionality, and operation of
possible implementations of systems, methods and computer program
products according to various embodiments of the present
disclosure. In this regard, each block in the flowchart or block
diagrams may represent a module, segment, or portion of code, which
comprises one or more executable instructions for implementing the
specified logical function(s). It should also be noted that, in
some alternative implementations, the functions noted in the block
may occur out of the order noted in the figures. For example, two
blocks shown in succession may, in fact, be executed substantially
concurrently, or the blocks may sometimes be executed in the
reverse order, depending upon the functionality involved. It will
also be noted that each block of the block diagrams and/or
flowchart illustrations, and combinations of blocks in the block
diagrams and/or flowchart illustrations, may be implemented by
special purpose hardware-based systems that perform the specified
functions or acts, or combinations of special purpose hardware and
computer instructions.
[0144] The terminology used herein is for the purpose of describing
particular embodiments only and is not intended to be limiting of
the disclosure. As used herein, the singular forms "a", "an" and
"the" are intended to include the plural forms as well, unless the
context clearly indicates otherwise. It will be further understood
that the terms "comprises" and/or "comprising," when used in this
specification, specify the presence of stated features, integers,
steps, operations, elements, and/or components, but do not preclude
the presence or addition of one or more other features, integers,
steps, operations, elements, components, and/or groups thereof.
[0145] The corresponding structures, materials, acts, and
equivalents of all means or step plus function elements in the
claims below are intended to include any structure, material, or
act for performing the function in combination with other claimed
elements as specifically claimed. The description of the present
disclosure has been presented for purposes of illustration and
description, but is not intended to be exhaustive or limited to the
disclosure in the form disclosed. Many modifications and variations
will be apparent to those of ordinary skill in the art without
departing from the scope and spirit of the disclosure. The
embodiment was chosen and described in order to best explain the
principles of the disclosure and the practical application, and to
enable others of ordinary skill in the art to understand the
disclosure for various embodiments with various modifications as
are suited to the particular use contemplated.
[0146] A number of implementations have been described. Having thus
described the disclosure of the present application in detail and
by reference to embodiments thereof, it will be apparent that
modifications and variations are possible without departing from
the scope of the disclosure defined in the appended claims.
* * * * *